Post-Surgery Flash Phenomena After Scleral Buckling: What to Know

Q: Post-Surgery Flash Phenomena After Scleral Buckling: What to Know

Hello Mr. Zhang： 1. If you notice any abnormalities, you should get checked. If the results are normal, use that as your baseline. If future results significantly differ from the baseline, further examination is needed; if they are similar, just monitor the si

Postoperative flashes after scleral buckle surgery?

Hello! At the end of January this year, I experienced a partial retinal detachment in my right eye (upper quadrant).
Initially, I underwent laser treatment, but after three months of follow-up, the condition of the retinal detachment worsened.
However, since the area of detachment was small and did not affect my central vision or macula, the doctor decided, after careful consideration and evaluation, to perform an air tamponade procedure.
Unfortunately, two weeks after the surgery, the detachment recurred.
Therefore, the doctor decided to proceed with a scleral buckle procedure combined with SF6 gas tamponade.
It has now been ten days post-surgery, and I am still following the doctor's instructions regarding eye drops and allowing my eye to rest.
During previous follow-up visits, the doctor mentioned that the retinal reattachment was progressing well and that the hole was being adequately supported.
However, about two days ago, I noticed flashes of light in my eye.
On that day, my primary physician was not available, but I was concerned about delaying treatment, so I immediately went to see another doctor for a fundus examination.
After the examination, the doctor explained that the retinal condition was good, with no new holes, and that the retina was attached.
However, he also mentioned that there might be a small amount of postoperative bleeding and gas within the eye, leading him to suspect that the flashes could be caused by either the intraocular gas or bleeding.
So far, the flashes have continued, but they occur at fixed times, typically in the afternoon or evening, about two times a day, not exceeding three times, with intervals of more than five hours between each occurrence (for example, one at 1 PM and another at 6 PM).
I am still somewhat worried, and I have a few questions for the doctor:
1.
Regarding the flashes, the doctor mentioned that if they persist, I should return for a follow-up.
What does "persist" mean? Does it refer to "multiple occurrences within a day" or "multiple occurrences within a specific time period"? Currently, I experience them daily, but the intervals are long, and the flashes have not intensified; each occurrence is similar.
Does this count as "persisting"?
2.
After the surgery, I sometimes feel a sharp pain in my eye (specifically in the upper right area where the surgery was performed).
However, if I close my eyes and rest or focus on one spot, this discomfort tends to ease (or even completely goes away).
Is this situation normal?
3.
If, unfortunately, there is a recurrence of retinal detachment or a tear in the same eye after surgery, is it still possible to treat it primarily with laser therapy? Based on the doctor's experience, what is the likelihood of re-detachment occurring in the same eye after surgery?
4.
Sometimes, when my heart races due to anxiety, I feel as if my eye is pulsating in sync with my heartbeat.
Could this affect the surgical outcome, or does it indicate any specific condition?
5.
Is it okay to sing for leisure after the surgery? I am concerned that singing might increase intraocular pressure.

Mr. Zhang, 20~29 year old female. Ask Date: 2022/05/15

Dr. Gao Pilin reply Ophthalmology

Hello Mr.
Zhang:
1.
If you notice any abnormalities, you should get checked.
If the results are normal, use that as your baseline.
If future results significantly differ from the baseline, further examination is needed; if they are similar, just monitor the situation.

2.
It is normal to experience discomfort after surgery, especially with pressure on the eyeball.
Looking to one side may provide relief.
Gradually, you should start to feel better.

3.
The more severe the preoperative condition, the higher the chance of re-detachment.
If the preoperative condition was not too severe and the surgery recovers well, the likelihood of re-detachment is lower.

4.
No, this is a normal phenomenon.

5.
You can sing.

Reply Date: 2022/05/15

More Info

Post-surgery experiences, particularly after procedures like scleral buckling for retinal detachment, can be complex and concerning for patients. Your description of experiencing flash phenomena, along with other symptoms, raises several important points that need to be addressed.

1. Understanding Flash Phenomena: The flashes of light you are experiencing could be related to several factors, including the presence of gas bubbles (from the SF6 air injection) or minor bleeding within the eye. These phenomena can occur as the retina heals and may be a normal part of the recovery process. The term "persistent" in a medical context usually refers to symptoms that occur repeatedly over a specific timeframe. In your case, since you are experiencing flashes daily, it would be considered persistent. However, the intervals between the flashes and their consistency in appearance are also important. If the flashes become more frequent, intense, or change in character, that would warrant immediate medical attention.

2. Post-operative Discomfort: The sensation of sharp pain or discomfort in the area of the surgery is not uncommon. This could be due to inflammation or irritation of the tissues surrounding the surgical site. Resting your eyes and avoiding strain can help alleviate these symptoms. If the pain persists or worsens, it is advisable to consult your ophthalmologist for further evaluation.

3. Risk of Re-detachment: The risk of re-detachment after surgery can vary based on several factors, including the initial cause of the detachment, the extent of the detachment, and the overall health of the retina. In some cases, laser treatment may still be an option if a new detachment occurs. However, the decision will depend on the specifics of the new detachment and the surgeon's assessment. It is essential to maintain regular follow-ups with your ophthalmologist to monitor the condition of your retina.

4. Perception of Pulsation: The sensation of your eye "pulsating" in sync with your heartbeat could be related to increased awareness of blood flow or pressure changes in the eye. While this sensation can be alarming, it does not necessarily indicate a problem with the surgery. However, if you experience significant discomfort or changes in vision, it is crucial to discuss these symptoms with your doctor.

5. Activities Post-Surgery: Engaging in activities like singing after surgery is generally acceptable, but it is wise to do so with caution. Singing does involve some degree of pressure changes in the body, which could theoretically affect intraocular pressure. If you feel comfortable and do not experience any discomfort while singing, it should be fine. However, if you notice any adverse effects, it would be best to limit such activities until you have fully recovered.

In conclusion, while some post-operative symptoms can be normal, it is essential to maintain open communication with your healthcare provider. Regular follow-ups and reporting any new or worsening symptoms will help ensure the best possible outcome for your recovery. If you have any concerns about your symptoms or the healing process, do not hesitate to reach out to your ophthalmologist for guidance. Your vision and eye health are paramount, and proactive management is key to a successful recovery.

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